Pathogenesis
Risk Factors for Inflammatory Bowel Disease
- Family history of inflammatory bowel disease
- Smoking (Crohn's only - protective in ulcerative colitis)
- Western diet - high fat, high sugar
- Medications - NSAIDs, oral contraceptives
- Not being breastfed
- Psychological stress
Manifestations
Manifestations of Inflammatory Bowel Disease
- Mouth ulcers
- Malabsorption
- Intestinal obstruction
- Anorectal disease - fissures, fistulae, abscesses
- Fistulae - anorectal, rectovaginal, enterocutaneous
- Malignancy - small bowel or colorectal cancer
Extra-Intestinal
- Dermatologic - erythema nodosum, pyoderma gangrenosum
- Musculoskeletal - enteropathic arthritis, osteoporosis
- Hepatic - primary sclerosing cholangitis, non-alcoholic fatty liver disease, cirrhosis, cholelithiasis (Crohn's)
- Renal - nephrolithiasis (calcium oxalate)
- Ocular - uveitis, episcleritis, conjunctivitis
Management
Management Options for Crohn's Disease
Non-Pharmacologic
- Smoking cessation
- Nutritional optimisation
- Psychologic supports
- Cancer surveillance
Pharmacologic
- Steroids - prednisolone, budesonide
- Thiopurines - azathioprine, 6-mercaptopurine
- Methotrexate
- TNF blockers - infliximab, adalimumab
Surgical
- Anorectal disease - fistulotomy, seton insertion
Next Page
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------